Pancho - LEM-MIR-69

Code: LEM-MIR-69
Mercy ID: V-00966-01
Encounter Date: 07/03/2002
Last: Lemus
First: Miriam
DOB: 04/01/1969
County: Dekalb
Street: 4198 Woodwin Court
City: Doraville
State: GA

Zip

30360-

Home

(770) 986-0052

Family Status

Single parent w/children

COB

Guatemala

Gender

Female

Housing

Not Homeless

Education Level

Grade school

Home Owner

YES

Parents Information

	Name	DOB	COB
Mother	N/A	N/A	N/A
Father	N/A	N/A	N/A
Step Parent	N/A	N/A	N/A

Driver: YES
Relative: No
Stranger: No
Lives With: N/A
Name of School: N/A
Grade: N/A
Who Can't Pickup the Child
Authoritation Parent: No
Authoritation Child: No
DOY PERMISO: No
Limitado Educativo: No
Limitado Impresos: No
Limitado Caminar Latino: No

Intake: J. Perez
Data Entry: K. Aleman